Chronotherapy for coronary heart disease.
Traditionally the therapy for coronary heart disease has been focused on the "how-to" problem. However, the clustering of cardiovascular events around the specific time of the day has been clarified. To solve the problems of the clustering would give us the clue to treat the coronary heart disease timely and in time. Therefore, the research has been stressed to solve "when-to" problem. The circadian variabilities in coronary heart disease has been clarified to be the function of the biologic time. Therefore, three problems were discussed in this paper. 1) The circadian variabilities in biology should be assessed based on the biologic zero hour rather than the mid-night of the mechanical clock. Our concept of the biologic zero hours has been proposed to answer this problem. 2) Daily health care with circadian order and harmony for the prevention of the coronary risk factors should be recommended as the prevention of the acute coronary risk factors as the trigger mechanism of the cardiovascular events. 3) The chronotherapy to chronic coronary risk factors such as hypertension was discussed, In hypertension the anti-hypertensive therapy should be customized individually adjusting the circadian variability of blood pressure with the proper selection of agents and time of the administration.
Tamura
K
K
Second Department of Medicine, Yamanashi Medical University, Japan.
Okutani
M
M
Kohno
I
I
Ijiri
H
H
D000959:Antihypertensive Agents / Q000008:administration & dosage; D018660:Blood Pressure Monitoring, Ambulatory; D019454:Chronotherapy; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D003695:Delivery of Health Care; D004110:Diltiazem / Q000008:administration & dosage; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D012307:Risk Factors; D014022:Tissue Survival
D000959:Antihypertensive Agents; D004110:Diltiazem